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This study tested the preliminary effectiveness of an electronic health record (EHR)-automated population health management (PHM) intervention for smoking cessation among adult patients of a federally qualified health center in Chicago. Participants (N = 190; 64.7% women, 82.1% African American/Black, 8.4% Hispanic/Latino) were self-identified as smokers, as documented in the EHR, who completed the baseline survey of a longitudinal “needs assessment of health behaviors to strengthen health programs and services.” Four weeks later, participants were randomly assigned to the PHM intervention (N = 97) or enhanced usual care (EUC; N = 93). PHM participants were mailed a single-page self-determination theory (SDT)-informed letter that encouraged smoking cessation or reduction as an initial step. The letter also addressed low health literacy and low income. PHM participants also received automated text messages on days 1, 5, 8, 11, and 20 after the mailed letter. Two weeks after mailing, participants were called by the Illinois Tobacco Quitline. EUC participants were e-referred following a usual practice. Participants reached by the quitline were offered behavioral counseling and nicotine replacement therapy. Outcome assessments were conducted at weeks 6, 14, and 28 after the mailed letter. Primary outcomes were treatment engagement, utilization, and self-reported smoking cessation. In the PHM arm, 25.8% of participants engaged in treatment, 21.6% used treatment, and 16.3% were abstinent at 28 weeks. This contrasts with no quitline engagement among EUC participants, and a 6.4% abstinence rate. A PHM approach that can reach all patients who smoke and address unique barriers for low-income individuals may be a critical supplement to clinic-based care.

Objective Rural residence has been related to health disparities and greater mortality risk in cancer patients, including gynecologic cancer patients. Lower survival rates for rural cancer survivors have been attributed to limited access to specialized healthcare, including surgery. Here, we examined whether a rural/urban survival gap existed in ovarian cancer patients receiving surgery at tertiary-care facilities, and potential causes for this gap, including educational attainment. Methods Rural and urban patients with high grade invasive ovarian cancer (n = 342) seeking treatment at two midwestern tertiary-care university hospitals were recruited pre-surgery and followed until death or censoring date. Rural/urban residence was categorized using the USDA Rural-Urban Continuum Codes. Stratified Cox proportional hazards regression analyses, with clinical site as strata, adjusting for clinical and demographic covariates, were used to examine the effect of rurality on survival. Results Despite specialized surgical care, rural cancer survivors showed a higher likelihood of death compared to their urban counterparts, HR = 1.39 (95% CI: 1.04, 1.85) p = 0.026, adjusted for covariates. A rurality by education interaction was observed (p = 0.027), indicating significantly poorer survival in rural vs. urban patients among those with trade school/some college education, adjusted HR = 2.49 (95% CI: 1.44, 4.30), p = 0.001; there was no rurality survival disparity for the other 2 levels of education. Conclusions Differences in ovarian cancer survival are impacted by rurality, which is moderated by educational attainment even in patients receiving initial care in tertiary settings. Clinicians should be aware of rurality and education as potential risk factors for adverse outcomes and develop approaches to address these possible risks.

The NCI P20 SPORE aims to support the feasibility, development and planning activities to build cancer research programs with a dedicated translational focus. The Northwestern University Cancer Health Equity Research SPORE (NU-CHERS) is entering its second year of collaboration with the Lurie Cancer Center and John H. Stroger, Jr. Hospital of Cook County (SHCC). NU-CHERS is dedicated to conducting translational research on gynecologic cancer disparities experienced by women of color in Chicago. This presentation will report the challenges and successes of establishing the nation's first gynecologic cancer disparity SPORE, focused on understanding the clinical disparities experienced by women in Chicago, to improve health outcomes and build trusting reciprocal relationships with the community. Success of NU-CHERS hinges on local partnerships to achieve the elimination of gynecologic cancer disparities. The Lurie Cancer Center has thirty years of experience in developing and implementing cancer research programs and infrastructure. SHCC is a publicly funded hospital that provides access to healthcare to patients, including the uninsured, through a sliding scale based on income or inability to afford insurance deductibles. SHCC also serves a diverse patient population, making it an ideal community partner to facilitate a deeper understanding of gynecologic cancer disparities in the region and develop a richly diverse specimen biobank. NU-CHERS leverages these partnerships to advance research specific to underrepresented groups most impacted by gynecologic cancer disparities that will ultimately establish equitable access to precision medicine oncologic treatments. Through partnerships and infrastructure development, our team has identified lessons learned, opportunities for improvement and challenges requiring even more courage to achieve mandated milestones. For example, for the crucial step of building a robust biobank of annotated specimens, NU-CHERS supported SHCC in adapting protocols to meet local site constraints, as well as aligning data collection capabilities within clinical constraints versus research interests. Other important program achievements fall under the categories of fostering collaborations with communities through partnership with trusted healthcare organizations to facilitate education and reciprocity; best practices for establishing a multi-site research initiative with a Single Institutional Review Board (sIRB); and advancing the work of research projects during a pandemic. Sharing these findings advances the work of eliminating cancer disparities by providing a blueprint for researchers to improve upon for their collaborative cancer disparities programs. NU-CHERS is committed to establishing strong local partnerships and infrastructure in the community and thus legitimizing translational research to leverage basic science discoveries into clinical practice improvements through all the tools afforded by basic and population science researchers. Citation Format: Denisha R. Brown, Laura Tom, Magdalena Nava, Catherine A. O'Brian, Ivy Leung, Rabih Dahdouh, Edgardo Ramirez, Araceli Estrada, Sankirtana Danner, Cassandra Osei, Will Dunne, Sharon Post, Nihmot Adebayo, Ann Yau, Terri Fraterrigo, Melissa A Simon. Building the country's first gynecologic cancer disparity SPORE: A labor of love [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-046.

// Desire K. Christensen 1 , Guillermo N. Armaiz-Pena 2 , Edgardo Ramirez 1 , Koji Matsuo 3 , Bridget Zimmerman 4 , Behrouz Zand 5, 6 , Eileen Shinn 7 , Michael J. Goodheart 8, 9 , David Bender 8 , Premal H. Thaker 10 , Amina Ahmed 11 , Frank J. Penedo 12 , Koen DeGeest 13 , Luis Mendez 14 , Frederick Domann 15 , Anil K. Sood 5, 6 , Susan K. Lutgendorf 1, 8, 9, 16 1 Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA 2 Department of Pharmacology, Ponce Health Sciences University, Ponce, Puerto Rico 3 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA 4 Department of Biostatistics, University of Iowa, Iowa City, Iowa, USA 5 Department of Gynecologic Oncology and Reproductive Medicine, UT MD Anderson Comprehensive Cancer Center, Houston, Texas, USA 6 Department of Cancer Biology, and Center for RNA Interference and Noncoding RNA, UT MD Anderson Comprehensive Cancer Center, Houston, Texas, USA 7 Department of Behavioral Science, UT MD Anderson Comprehensive Cancer Center, Houston, Texas, USA 8 Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa, USA 9 Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA 10 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University, St. Louis, Missouri, USA 11 Department of Obstetrics and Gynecology, Lutheran General Hospital, Park Ridge, Illinois, USA 12 Department of Medical Social Sciences, Northwestern University, Chicago, Illinois, USA 13 Division of Gynecologic Oncology, Oregon Health and Sciences University, Portland, Oregon, USA 14 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Florida International University School of Medicine, Miami, Florida, USA 15 Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA 16 Department of Urology, University of Iowa, Iowa City, Iowa, USA Correspondence to: Susan K. Lutgendorf, e-mail: susan-lutgendorf@uiowa.edu Keywords: selective serotonin reuptake inhibitors, epithelial ovarian cancer, serotonin, progression, cell proliferation Received: November 09, 2015 Accepted: April 02, 2016 Published: April 21, 2016 ABSTRACT Selective serotonin reuptake inhibitor (SSRI) use is common among ovarian cancer patients. We examined the effect of SSRIs on survival and progression in ovarian cancer patients and effects of 5-HT on ovarian cancer cell (OCC) proliferation. Ovarian cancer patients from a 6-site study between 1994 and 2010 were included. Cox proportional hazards models were used for multivariate analysis. SSRI use was associated with decreased time to disease recurrence (HR 1.3, CI 1.0-1.6, p =0.03), but not overall survival (HR 1.1, CI 0.9-1.3, p =0.56). Compared to normal ovarian cells, most OCCs had elevated 5-HT2A receptor mRNA expression (up to 1600 fold greater expression). Clonogenic survival increased in cells treated with 10 uM (1.6 fold, p

Receptor desensitization, or decreased responsiveness of a receptor to agonist stimulation, represents a regulatory process with the potential to have a significant impact on cell behavior. P2Y(2), a G-protein-coupled receptor activated by extracellular nucleotides, undergoes desensitization at many tissues, including the vascular endothelium. Endothelial cells from a variety of vascular beds are normally exposed to extracellular nucleotides released from damaged cells and activated platelets. The purpose of the present study was to compare P2Y(2) receptor desensitization observed in endothelial cells derived from bovine retina, a model of microvascular endothelium, and human umbilical vein endothelial cells (HUVECs), a model of a large blood vessel endothelium. P2Y(2) receptor desensitization was monitored by following changes in UTP-stimulated intracellular free Ca(2 +) in single cells using fura-2 microfluorometry. Both endothelial cell models exhibited desensitization of the P2Y(2) receptor after stimulation with UTP. However, the cells differed in the rate, dependence on agonist concentration, and percentage of maximal desensitization. These results suggest differential mechanisms of P2Y(2) receptor desensitization and favors heterogeneity in extracellular nucleotide activity in endothelial cells according to its vascular bed origin.

A finite element method based on a least-squares mixed formulation is presented to estimate the coefficient in a boundary value problem. Error estimates are obtained in weighted norms of various function spaces which lead to useful rules for choosing regularization parameters and finite element spaces. The cost functional has a structure suitable for efficient finite element implementation. Common minimization algorithms are shown to converge. A multi-level Newton iteration procedure is suggested to find the minimizer. Features of the method are also demonstrated by numerical examples.

303 Background: Limited opportunities exist to conduct population-based surveillance of cancer patient-reported outcomes. Data from the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program has recently been linked with data from two Centers for Medicare & Medicaid Services quality improvement surveys: the Medicare Health Outcomes Survey (MHOS) and the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys. We provide an overview of the data available, recent findings, and priority areas for future research. Methods: Since 1998, the MHOS has conducted 2-wave/biennial surveys of individuals ages 65+ and individuals with disabilities enrolled in Medicare Advantage (MA) health plans on aspects of health-related quality of life, functional status, comorbidities, and symptoms. Fourteen cohorts are available, representing over 126K patients with cancer and over 1.9 million MA enrollees without a history of cancer. The SEER-MHOS publicly available data resource has produced over 40 data use agreements and 19 publications. SEER-CAHPS links cancer registry data with cross-sectional survey data of Medicare beneficiaries (both fee-for-service and MA) that contain information on patient experiences with care, including access to needed and timely care, doctor communication, health plan customer service, and care coordination. The current linkage contains survey data from 1998 to 2010 and includes over 150K and 570K respondents with and without a history of cancer, respectively. Plans to launch the publicly available resource are underway. Results: Recent findings include the impact of diagnosis and treatment on health-related quality of life in older cancer survivors, physical health impairments and variation of treatment received, the impact of cancer on activities of daily living, and variations in care ratings between participants with and without cancer across the cancer control continuum. Conclusions: The SEER-MHOS and SEER-CAHPS linked data resources provide population-based surveillance data on cancer patient-reported outcomes which allow unprecedented opportunities to evaluate national quality improvement activities.